Accuracy of telomerase in cervical lesions: a systematic review

Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Pôrto de São Francisco dos Casaes, Rio Grande do Sul, Brazil
International Journal of Gynecological Cancer (Impact Factor: 1.95). 11/2007; 17(6):1205-14. DOI: 10.1111/j.1525-1438.2007.00980.x
Source: PubMed

ABSTRACT The detection of telomerase activity in cervix may provide information on cervical carcinogenesis and may be a marker to monitor cervical intraepithelial neoplasia transition. A quantitative systematic review was performed to estimate the accuracy of telomerase assay in cervical lesions. Studies that evaluated the telomerase test (telomerase repeated amplification protocol) for the diagnosis of cervix lesions and compared it to paraffin-embedded sections as the diagnostic standard were included. Ten studies were analyzed, which included 1069 women. The diagnostic odds ratio (DOR) for a positive telomerase test for low-grade squamous intraepithelial lesions (Lo-SIL) vs normal or benign lesions was 3.2 (95% CI, 1.9-5.6). The DOR for a positive telomerase test for high-grade squamous intraepithelial lesions (Hi-SIL) vs Lo-SIL, normal or benign lesions was 5.8 (95% CI, 3.1-10). For cervix cancer vs Hi-SIL, the DOR for a positive telomerase test was 8.1 (95% CI, 3.2-20.3) and for cervix cancer vs Lo-SIL, normal or benign lesions, it was 40.9 (95% CI, 18.2-91). Our data support the current hypothesis that telomerase may activate an early event in cervical carcinogenesis that could be associated with the initiation and progression of cervical lesions.

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    Estado del Arte de la Medicina 2013–2014: Biología médica., Primera edición edited by Enrique Ruelas Barajas, Alberto Lifshitz Guinzberg, Jaime Mas Oliva, 12/2014: chapter Capítulo 5: Biotecnología: investigaciones con genes de impacto en la salud.: pages 61-67; CONACYT. Intersistemas, S.A. de C.V.., ISBN: 978-607-443-492-7.
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    ABSTRACT: Human papillomavirus (HPV) has been estab- lished as an important etiological factor for the development of cervical cancer. This DNA virus primarily infects the epithelium and can induce benign and malignant lesions of the mucous membranes and skin. Some HPVs are considered high risk due to their role in ma- lignant progression of cervical tumors. Genital HPV infections are common and usually tran- sient among young sexually active women. Only a small fraction of infected women devel- op cervical cancer, implying the involvement of environmental and genetic cofactors in cer- vical carcinogenesis. Classification, virology, pathology, natural history, epidemiological features of genital HPV infection, and future prospects for cervical cancer prevention with HPV vaccines will be reviewed here.
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    ABSTRACT: Cervical cancer is the second type of women cancers, most cases being reported in the developing countries where it represents the main cause for mortality in women. The aim of this study was to clarify the role of hTERT expression levels in cervical carcinogenesis, in each type of cytological diagnostic group (normal/inflammatory, ASCUS, LSIL, HSIL, cancer groups) like potential diagnostic marker. Methods: The smears obtained from 50 women with/without suggestive HPV infection pathology were cytological investigated. The viral testing was based on the presence of HPV DNA using the IINNOLIPA kit and semi-quantitative expression levels of hTERT were estimated in RT-PCR. Results: HPV was present in 84% of the examined cases, but only in 40.48% of them hTERT expression was observed. hTERT mRNA was detected in 17.65% cytologically normal/inflammatory patients, in 30% patients with ASCUS, 61.50% patients presenting LSIL and 70% patients with HSIL/cancer. hTERT mRNA expression was significantly increased in LSIL (p = 0.035) and HSIL/cancer (p=0.0044) as compared with normal group, but hTERT expression in ASCUS patients group does not present statistical significance as compared with the normal group (p=0.37). The association between the expressions of hTERT, the presence of hrHPV as well as dysplasia grade suggests that the hTERT activation may be a central mechanism by which HPV infections lead to malignant transformation. Analysis of hTERT expression can be used in diagnosis to decrease the false-negative cytology tests but only as an adjuvant, requiring correlation with the results of morphological feature.